Concerted efforts needed to save children from malnutrition

Esther, a mother of four is afraid her third born daughter carol,5, might end up becoming malnourished.

Carol, who will be joining standard one next year seems to have no interest in food at all. Her mother has tried everything she could think of to make her daughter like food, including trying different varieties but all in vain.

Carol eats very little food and as a result, remains the thinnest of Esther’s four children. While Esther provides her with a balanced diet, she fears her daughter may end up lacking the necessary nutrients her body needs for growth.

Malnutrition is a broad term which refers to both under-nutrition and over-nutrition. Individuals are malnourished, or suffer from under-nutrition if their diet does not provide them with adequate calories and proteins for maintenance and growth, or they cannot fully utilize the food they eat due to illness.

People are also malnourished, or suffer from over-nutrition if they consume too many calories. People who don't get enough food often experience hunger, and hunger can lead to malnutrition over the long term. But someone can become malnourished for reasons that have nothing to do with hunger. Even people who have plenty to eat may be malnourished if they don't eat food that provides the right nutrients, vitamins, and minerals.

A child who doesn't get enough of one specific nutrient has a nutritional deficiency; a form of malnutrition (although it doesn't necessarily mean the person will become seriously ill). The most common form of malnutrition in the world is iron, iodine and vitamin A deficiencies, which can lead to anemia.

Malnutrition contributes much to deaths of children from zero to two years since it is the insufficient, excessive or imbalanced consumption of nutrients. So hunger, malnutrition and lack of a balanced diet are among major causes of three quarters of all deaths of children under the age of five in Tanzania.

Chronic malnutrition is endemic in Tanzania, with 42 percent of under fives stunted, making Tanzania one of the 10 worst affected countries in the world and the third worst affected in Africa.

A global report by Save the Children; A Life Free from Hunger: Tackling Child Malnutrition’, shows at least 130 children in Tanzania die everyday from causes related to malnutrition. Four out of five of them under the age of five suffer from chronic malnutrition.

Ibrahim Mwema from the Temeke Children’s council said at a recent conference on malnutrition organized by Save the Children in Dar es Salaam that some parents lacked education on malnutrition and the importance of a balanced diet and thus failed to provide their children with a balanced diet.
Mwema wondered as to who should be blamed for not educating the society on the importance of a balanced diet to children and adults in general.

He urged the government to allocate enough funds for education on food and nutrition especially in schools and hospitals.
However, he said government needs to emphasise on the use of fresh farm foods instead of canned foods so as to build a nation of healthy children.

“Fresh food is affordable to all classes of people in society but continuing promoting the food from supermarkets is to rear children, who suffer from malnutrition,” said the young man.
Despite various national commitments to reduce malnutrition, the problem is yet to attract enough political attention and does not feature high on the development agenda.

Iringa Special Seats MP, Lediana Mng’ong’o who also attended the children’s gathering said in order to have a nation whose children are free from malnutrition, it is time the government hired nutrition experts. She said if possible, these should come from municipal council level to regional level. The MP said these experts will help educate people on nutrition and balanced diet.

Mng’ong’o said children’s rights must be recognized by all Tanzanians including giving them opportunities to express their feelings and teach them to know what a balanced diet is all about.

Prof. Joyce Kinabo, a nutrition ambassador from Partnership for Nutrition in Tanzania (PANITA), who is also an Associate Professor from the Sokoine University of Agriculture said disease and inadequate dietary intake are two of the immediate causes of malnutrition in children, women, and other population groups in Tanzania.

According to her, they often occur together and are caused by multiple underlying factors including inadequate access to food and health services, an unhealthy environment as well as inadequate caring practices.

In its report, Save the Children shows that rising food prices and malnutrition were putting additional pressure on countries with already high burdens of child mortality. Unless tackled now, the report continues, over the next 15 years, a further half a billion children’s lives around the world will be left blighted by malnutrition.

The nutrition Ambassador said the survey shows a snap-shot of the hardship that families are facing in countries where, even before food price spikes, many of the poorest children were already surviving on a diet dominated by a basic staple such as white rice, maize or cassava, which has very low nutritional value.

The charity’s report has revealed that 15 million more children are suffering from chronic malnutrition in Africa now compared to 1990. Today, nearly two in five African children are malnourished totaling to 60 million, a figure expected to rise by 8.5 million this decade if current trends continue. Of these, 450,000 are in Tanzania.

Meanwhile, a new global survey conducted by the same charity showed in five countries where more than half of the world’s malnourished children live, Nigeria, Pakistan, Peru, India and Bangladesh that is, half of all families have been forced to cut back on food. A third complained their children did not have enough food to eat.

With hidden sorrow, she said progress against malnutrition crisis had been slower in Tanzania and Africa generally than else where in the world, with soaring food prices and economic downturn in the last year making it even harder for families to buy enough of the right type of food for their children as they grew up.

“I am happy to say that Tanzania is not starting from scratch… so far it has achieved some very good results, including development and finalization of the National Nutrition Strategy for 2010-2015 containing the framework for the government and its partners to work jointly on nutrition issues. But at current rates of malnutrition, Tanzania will not meet the Millennium Development Goal 1 of reducing extreme poverty and hunger which has a component of halving the 1990 rates of child underweight status by 2015,” Prof. Kinabo said.

Rachel Pounds, Country Director of Save the Children in Tanzania said inequities in nutritional status continue to persist, with most malnourished children and women living in rural areas, thus more efforts need to be done to rescue them.
Although malnutrition is the underlying cause of a third of child deaths in the world (2.6 million each year), it has not received the same high-profile campaigning and investment as other causes of child mortality like HIV/Aids or malaria. This has meant that while the child mortality rate from malaria has been cut by a third since 2000, child malnutrition rates in Africa have decreased by less than 0.3% .

Recognizing its responsibility towards children’s right to adequate nutrition, the government of Tanzania has signed and ratified the UN Convention on the Rights of the Child, the African Charter on the Rights and Welfare of the Child, and embraced both the 2000 Millennium Declaration leading to the Millennium Development Goals (MDGs) and the Scaling up Nutrition movement.

At the national level, it developed Vision 2025 and poverty reduction strategies (MKUKUTA I and II and MKUZA I and II for Tanzania mainland and Zanzibar, respectively). These policy commitments envision a significant reduction in the number of stunted children.

The government also recently launched its National Nutrition Strategy 2011/12 – 2015/16, and made a commitment to establish a designated line in the national budget for nutrition for the financial year 2012/13.

However, these high-level commitments still need to be translated into well-funded, well-coordinated concrete actions that result in the improvement of children’s nutritional status.